中药改善心肌损伤:线粒体钙稳态介导巨噬细胞自噬与焦亡的作用途径  

Improvement of myocardial injury by traditional Chinese medicine:mitochondrial calcium homeostasis mediates macrophage autophagy and pyroptosis pathway

作　　者：刘凌云 何贵新[2] 秦伟彬 宋惠 张利文 唐伟智 杨斐斐 朱子一 欧阳彬 Liu Lingyun;He Guixin;Qin Weibin;Song Hui;Zhang Liwen;Tang Weizhi;Yang Feifei;Zhu Ziyi;Ou Yangbin(Guangxi University of Chinese Medicine,Nanning 530299,Guangxi Zhuang Autonomous Region,China;First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning 530230,Guangxi Zhuang Autonomous Region,China)

机构地区：[1]广西中医药大学,广西壮族自治区南宁市530299 [2]广西中医药大学第一附属医院,广西壮族自治区南宁市530230

出　　处：《中国组织工程研究》2025年第6期1276-1284,共9页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金地区基金项目(81960861),项目负责人:何贵新;广西自然科学基金重点项目(2020GXNSFDA297020),项目负责人:何贵新;广西中医药大学自然科学基金面上项目(2023MS023),项目负责人:秦伟彬;广西中医药大学桂派中医药传承创新团队-疑难重症中医诊疗研究团队(2022A001),项目负责人:何贵新。

摘　　要：背景:心肌损伤修复过程涉及复杂的细胞和分子机制,尤其是线粒体钙稳态、巨噬细胞的自噬与焦亡途径。中药在改善心肌损伤方面有显著的临床疗效,但其作用机制尚需深入研究。目的:探讨线粒体钙稳态介导的巨噬细胞自噬与焦亡途径在心肌损伤中的作用,并总结中药在这一领域的研究进展。方法:计算机检索Web of Science、PubMed及中国知网等数据库,从建库至2024年3月的相关文献。中文检索词为“线粒体钙稳态,巨噬细胞自噬,巨噬细胞焦亡,中药,心肌损伤,心肌损伤再灌注”等;英文检索词为“Mitochondrial calcium homeostasis,Macrophage autophagy,Macrophage pyroptosis,Traditional Chinese medicine,Myocardial injury”等。通过文献回顾分析线粒体钙稳态与巨噬细胞自噬、焦亡之间的关系,探究其在心肌损伤中的作用机制,总结中药多靶点、多通路影响的途径。结果与结论:①研究发现,线粒体钙稳态的维持与心肌细胞功能的正常运转密切相关。巨噬细胞可通过自噬与焦亡途径参与心肌损伤的修复过程,自噬有助于细胞的清除和炎症反应的调节,而焦亡则可通过释放炎症因子影响心肌修复。②中医药通过多种机制调节线粒体钙稳态和巨噬细胞功能,如黄芪甲苷通过降低线粒体膜电位和抑制细胞色素C来调节钙稳态,淫羊藿苷通过减少β-淀粉样蛋白沉积来发挥作用;中药复方和单味药物通过激活或抑制特定的信号通路,如PI3K/AKT、核因子κB等通路来促进心肌损伤的修复。③未来的研究应关注线粒体钙稳态、自噬与焦亡途径的相互作用,以及中药如何通过这些途径发挥治疗作用,为心肌损伤的治疗提供新的策略和药物。BACKGROUND:The repair process of myocardial injury involves complex cellular and molecular mechanisms,especially mitochondrial calcium homeostasis,macrophage autophagy and pyroptosis pathways.Traditional Chinese medicine(TCM)has shown significant clinical efficacy in improving myocardial injury,but its mechanism of action needs to be thoroughly investigated.OBJECTIVE:To investigate the role of mitochondrial calcium homeostasis-mediated macrophage autophagy and pyroptosis pathways in myocardial injury,and to summarize the progress of TCM in this field.METHODS:A computerized search was performed for relevant literature from the database inception to March 2024 in the Web of Science,PubMed and CNKI.The search terms were“mitochondrial calcium homeostasis,macrophage autophagy,macrophage pyroptosis,traditional Chinese medicine,myocardial injury,myocardial injury reperfusion”in Chinese and English.Through literature review,we analyzed the relationship between mitochondrial calcium homeostasis and macrophage autophagy and pyroptosis,explored the mechanism of their roles in myocardial injury,and summarized the pathways of multi-targeted,multipathway effects of TCM.RESULTS AND CONCLUSION:The maintenance of mitochondrial calcium homeostasis has been found to be closely related to the normal function of cardiomyocytes.Macrophages can participate in the repair process of myocardial injury through autophagy and pyroptosis pathways.Autophagy contributes to cell clearance and regulation of inflammatory response,while pyroptosis affects myocardial repair by releasing inflammatory factors.TCM regulates mitochondrial calcium homeostasis and macrophage function through multiple mechanisms.For example,astragalosid regulates calcium homeostasis by lowering mitochondrial membrane potential and inhibiting cytochrome C,and epimedium glycoside plays a role in reducing β-amyloid deposition.In addition,herbal compounds and single drugs promote myocardial repair by activating or inhibiting specific signaling pathways,such as PI3K/AKT an

关 键 词：线粒体钙稳态 巨噬细胞自噬 巨噬细胞焦亡 中医药 心肌损伤 

分 类 号：R496[医药卫生—康复医学] R318[医药卫生—临床医学] R541